Five-year survival rates for childhood cancers have improved dramatically since the early 1960s, more than doubling for four of the five most common pediatric neoplasms in the U.S. However, improvements in survival from primary brain and other central nervous system (BCNS) tumors (the second most frequent group of tumors in children) have been more gradual, increasing only from 35% to 55%. It has been recognized that blacks and members of lower socioeconomic status (SES) groups have higher mortality patterns for many adult caners than do whites and wealthier individuals. Race and SES are so interrelated in the U.S. that several researchers have studies whether the effects of race on cancer incidence and mortality may be explained by differences in SES. Despite considerable literature on the subject, no consensus has been reached, although the roles of race and poverty may be different depending upon the specific type of tumor involved. Numerous investigations have looked at the effects of race, SES, and major clinical prognostic factors in adult tumors (although not for BCNS tumors), but to date no one has considered all three of these variables simultaneously for childhood neoplasms. More than 1200 cases of primary BCNS tumors diagnosed between 01/01/70- 12/31/89 have been registered in the Greater Delaware Valley Pediatric Tumor Registry. This Registry is the largest population-based pediatric cancer registry in the nation, covering 31 counties in four states and a base population of almost two million children under the age of 15. Using this database, this investigation will, for the first time, help elucidate the roles of race, SES, and major clinical prognostic factors evaluated separately and simultaneously as they relate to survival from primary BCNS tumors in children. The measure of SES used will be the health insurance status of the patient at diagnosis. Although not often used as a measure of socioeconomic status, health insurance status is not without precedent and has the advantage of being available for more than 90% of cases (versus the more usual measures of SES where data are available for fewer than half the patients), so few cases will be excluded from analysis. Effects of race, age, major clinical prognostic factors at diagnosis, and initial treatment received will be analyzed to test the hypothesis that health insurance status is an independent predictor for survival from childhood primary BCNS cancers. If the hypothesis is confirmed, these results will have increasingly significant ramifications as the population of medically- uninsured/underinsured Americans continues to grow.